OFFICIAL TELLS OF OREGON WORKERS' COMP PLAN; STATE CALLED LEADER IN REFORM

In Oregon, legislators and reformers decided to get back to the basics of workers' compensation: a compromise between employer and employee.

After seven years and two rounds of legislative reforms, Gary Weeks says progress is being made, and Oregon often is cited as a leader in workers' compensation reform.

Weeks serves as director of the Oregon Department of Insurance and Finance. The department regulates, among other things, insurance, workers' compensation and occupational safety and health laws.

He spoke to members of the Southeast Missouri Business Group on Health at a Friday luncheon.

Missouri, Weeks said, has made the first step toward improving the state's workers' compensation system. But, he said, the first step likely won't be enough.

In Oregon, reform efforts began in 1987. "We looked back at what workers' compensation was really intended to do," Weeks said.

The system started in 1913 as an agreement between employers and employees whereby employees agree to waive their right to sue their employers in return for medical care paid for by the employer.

"But over the years, around workers' compensation grew up a number of what I call cottage industries that don't provide benefits to the two primary partners," he said.

"There was no incentive for injured employees to go back to work. We had excessive litigation and rising medical costs."

Today, Oregon's recipe for success calls for:

Emphasis on workplace safety and health.

Timely, appropriate and effective medical treatment.

Commitment to early return to work programs.

Consistent application of fair and objective standards for determining existence and extent of disability.

Timely delivery of fair compensation benefits.

Aggressive response to fraud.

Effective dispute resolution strategies.

As a result of the efforts, Weeks said disability claims fell from a high of 43,000 in 1988 to 30,000 in 1992. During that same time employment grew from 1.1 million to 1.3 million.

Fatalities dropped from eight-per-100 workers in 1986 to five per 100 in 1992.

"That may not sound like much, but we are actually talking about hundreds of millions of dollars savings to the system," Weeks said.

The reform looked at improving safety and health issues.

"We determined that the traditional OSHA approach to safety pure enforcement, including investigation, and, when a violation was found, imposing a fine hasn't worked. Some employers consider that a cost of doing business."

In Oregon, the state run OSHA department began offering consultations to businesses voluntary, free worksite inspections to identify hazards and determine how and where to get the best fix.

Today, the consultation program has 800 employers on a waiting list.

Also, all employers with 10 or more employees must have a safety committee and businesses face stiffer fines for infractions.

The state initiated a preferred worker program to encourage businesses to hire injured workers. For example, the state pays 50 percent of wages for six months, provides up to $25,000 to retrofit the workplace, and buys new tools.

To the benefit of employees, Weeks said, "We have doubled benefits for permanently partially disabled and totally disabled workers."

To help contain medical costs, the state set in place fee schedules and managed-care organizations. Also, primary care physicians are the only ones recognized as attending physicians in workers' compensation cases and are the only ones to authorize time loss.

The reform movement also included elements to take workers' compensation cases out of the courts whenever possible.

"There are big bucks to be made in workers' compensation cases," Weeks said. "TV ads are seen all the time: `If you were injured on the job, call us.'"

In an effort to curb litigation, the state set a second tier of administrative reviews in place to reconsider all cases. Weeks said 37 percent of cases that previously would have gone to litigation are resolved through the process.

Additional reforms Weeks is working toward include "seamless" insurance care. A combined workers' compensation and health insurance program would pay for injuries or illness regardless if they are work related.